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NPI Code Detail

MEDICARE: CHRYSTA STUART

MEDICARE: CHRYSTA STUART
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior Analyst

General Provider Information

NPI Number : 1184264673
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRYSTA STUART
Provider Business Mailing Address
First Line : 7485 PHELAN BLVD
Second Line :
City : BEAUMONT
State : TX
Zip : 77706-5748
Country : US
Telephone Number : 409-842-9898
Fax Number :
Provider Business Practice Location Address
First Line : 7485 PHELAN BLVD
Second Line :
City : BEAUMONT
State : TX
Zip : 77706-5748
Country : US
Telephone Number : 409-842-9898
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/13/2020
Last Update Date : 01/13/2020

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Directions to “ CHRYSTA STUART ” Practice Location

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